Evidence map›Paper›PMID 25575908›Full record

SynthesisJournal of general internal medicine2015

Do statins impair cognition? A systematic review and meta-analysis of randomized controlled trials.

Brian R Ott, Lori A Daiello, Issa J Dahabreh, Beth A Springate, Kimberly Bixby, Manjari Murali, Thomas A Trikalinos

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of general internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 103 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
103citing papers in PubMed, 9 pooled it
25.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

103 citing papers in PubMed, 9 syntheses or guidelines pooled it, 234 citations in OpenAlex.

  1. Pooled it
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  4. The efficacy of statins in the treatment of Alzheimer's disease: a meta-analysis of randomized controlled trial.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2020
    Pooled it
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  8. Statins for the prevention of dementia.The Cochrane database of systematic reviews · 2016
    Pooled it
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  10. Trial
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43 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Brian R OttRhode Island Hospital, Department of Neurology, Alpert Medical School of Brown University, Providence, RI, USA, BOtt@brown.edu.
Lori A Daiello
Issa J Dahabreh
Beth A Springate
Kimberly Bixby
Manjari Murali
Thomas A Trikalinos
Brown University · USRhode Island Hospital · USProvidence College · US

Funding

AHRQ HHS K08 HS017735
6 · The paper itself

Abstract

backgroundIn 2012, the United States Food and Drug Administration (FDA) issued a warning regarding potential adverse effects of HMG-CoA reductase inhibitors (statins) on cognition, based on the Adverse Events Reporting System and a review of the medical literature. We aimed to synthesize randomized clinical trial (RCTs) evidence on the association between statin therapy and cognitive outcomes.

methodsWe searched MEDLINE, EMBASE, and Cochrane CENTRAL through December 2012, and reviewed published systematic reviews of statin treatment. We sought RCTs that compared statin treatment versus placebo or standard care, and reported at least one cognitive outcome (frequency of adverse cognitive events or measurements using standard neuropsychological cognitive test scores). Studies reporting sufficient information to calculate effect sizes were included in meta-analyses. Standardized and unstandardized mean differences were calculated for continuous outcomes for global cognition and for pre-specified cognitive domains. The main outcome was change in cognition measured by neuropsychological tests; an outcome of secondary interest was the frequency of adverse cognitive events observed during follow-up.

resultsWe identified 25 RCTs (all placebo-controlled) reporting cognitive outcomes in 46,836 subjects, of which 23 RCTs reported cognitive test results in 29,012 participants. Adverse cognitive outcomes attributable to statins were rarely reported in trials involving cognitively normal or impaired subjects. Furthermore, meta-analysis of cognitive test data (14 studies; 27,643 participants) failed to show significant adverse effects of statins on all tests of cognition in either cognitively normal subjects (standardized mean difference 0.01, 95% confidence interval, CI, -0.01 to 0.03, p = 0.42) or Alzheimer's disease subjects (standardized mean difference -0.05, 95% CI -0.19 to 0.10, p = 0.38).

conclusionsStatin therapy was not associated with cognitive impairment in RCTs. These results raise questions regarding the continued merit of the FDA warning about potential adverse effects of statins on cognition.

Indexed as

Randomized Controlled Trials as TopicCognition DisordersHumansHydroxymethylglutaryl-CoA Reductase InhibitorsNeuropsychological TestsHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID25575908
PMCPMC4351273
OpenAlexW2021222203

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.